The Obscure Penalty Clause In Relation To Icd-10 Conversion

By Author: jvionhealth health
Total Articles: 11
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The ICD refers to the International Classification of Diseases as mandated by the World Health Organization and modified by the US federal government and renamed it ICD-10-CM. The department of Health and Human Services has set a deadline of Oct. 1 2013 for health providers with ICD-9 versions volumes 1, 2 and 3 to implement the ICD-10 conversion. It is important to distinguish the reporting mechanism and in-patient procedures, which are covered by the regulation, and the Healthcare Common Procedure Coding System which is still the standard for reporting ambulatory processes.

Will I face a prison term?

There is a lot of wrong information surrounding the new regulations. If you are worried about getting false information, you can to the website of Healthcare Information and Management Systems Society or HIMSS for ICD-10 information.

To answer the question of whether you might be imprisoned for violating the new regulations, the answer is no. Even the fines are very vague since the federal government has not issued any penalty matrix just yet although talks are ongoing to fine-tune the penalty clause of the ...
... law. However, you are still liable if you fail to beat the Oct. 1, 2013 deadline under the Health Insurance Portability and Accountability Act of 2003. Initial reports reveal that the violator might pay upwards of $25,000 for multiple violations.

More than the penalties

There are other negative impacts caused by the non-compliance. First are the reimbursement claims from insurance companies which could, and rightly so, refuse to pay because the documents are not presented under the new ICD-10 regulations; or the insurance companies can delay the payments and you should really feel lucky if they indeed honor the reimbursement claims.

Second, failing to comply with the new requirements will leave you on an island by yourself. Being flagged by health care regulators and insurance companies as a consistent violator of ICD-10 services will drastically impact on your company brand and reputation.

Not going to be easy

Of course, nobody said the conversion is easy. In fact, everybody warns that the ICD-10 conversionis going to be hard and complicated. You will need to overhaul the administrative and clinical systems that cover diagnosis codes. For instance, you have to change the medical diagnosis codes to 67,000 from the current 14,000, and the procedure codes to 85,000 from the current 13,000. To ensure that your system is up to the standards, you can employ a service provider that specialises in ICD-10 technology and conversion.